Healthcare Provider Details

I. General information

NPI: 1295751246
Provider Name (Legal Business Name): DAVID M GOLDBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MAMARONECK AVE STE 402
HARRISON NY
10528-1614
US

IV. Provider business mailing address

550 MAMARONECK AVE STE 402
HARRISON NY
10528-1614
US

V. Phone/Fax

Practice location:
  • Phone: 914-999-2100
  • Fax: 914-595-3211
Mailing address:
  • Phone: 914-999-2100
  • Fax: 914-595-3211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number154694
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: